Today, many people are taking positive steps to reduce the risks posed by major health problems like cancer, cardiopulmonary diseases, hypertension, and diabetes. But there’s one disease that makes the top-ten list of worldwide health conditions, and yet isn’t thought about as much as many of the others. That malady is severe periodontal (gum) disease — and according to a new study, it’s the sixth-most prevalent health condition in the world.
The study, released by the International and American Associations for Dental Research, reveals that some 743 million people around the world — about 11 percent of the global population — suffer from severe periodontal disease; that percentage hasn’t changed significantly since 1990. The study also shows that while an individual’s chance of developing this condition rises gradually with age, there is a steep increase in people between 30 and 40 years old, with a peak at age 38.
If severe periodontal disease is such a major concern, why isn’t it “on the radar”? A 2010 report from the U.S. Surgeon General, titled “Oral Health: The Silent Epidemic,” gives some clues. For one thing, diseases related to oral health don’t always produce dramatic symptoms: Even tooth loss, for example, is sometimes (wrongly) regarded as an inevitable consequence of aging, when it’s more often the result of disease or injury. For another, these conditions disproportionately affect people whose voices aren’t always heard: children, the elderly, and the disadvantaged.
Severe periodontal disease is clearly a challenge to the public health. But what can you do as an individual? Plenty! The good news about periodontal disease is that it is largely preventable, and very treatable. Prevention is chiefly a matter of maintaining good oral hygiene.
Have you flossed lately? Is your brushing technique up to snuff? Do you avoid sugary snacks and beverages (especially between meals), and visit your dentist for regular checkups? If so, you’ve taken some major steps toward preventing periodontal disease. But despite their best efforts, it is difficult for some people to control periodontal disease without extra assistance. That’s where a periodontist can help.
Periodontists are concerned with treating problems of the gums. We use a number of methods to combat periodontal disease — including removing plaque bacteria, restoring healthy tissue, and educating people about how to maintain better oral hygiene at home. Your general dentist may refer you to a periodontist if warning signs are noticed, but you don’t need a referral to come in for an exam. If you notice the symptoms of periodontal disease — redness or inflammation of the gums, a bad taste or odor in your mouth, or any amount of bleeding when you brush — then it may be time to have your gums checked.
Dental implants are today’s closest restorative facsimile to natural teeth. And they’re versatile: not only can they replace single teeth but they can also support bridges or dentures.
But since one of their crucial components is made of metal, are you out of luck obtaining this state-of-the-art dental restoration if you have a metal allergy?
The answer is: probably not—it’s rare for implants to cause an allergic reaction. Still, metal allergies can be a potential problem within your mouth as with other areas of health.
An allergy originates from the body’s necessary response to potentially harmful microorganisms or substances. Sometimes, however, this response becomes chronic and exaggerated, creating an allergy. People can have allergies to nearly anything with responses ranging from a minor rash to a potentially life-threatening multi-organ system shutdown (anaphylactic shock).
A small number of people have allergies to particular metals. One of the most common is nickel, which affects an estimated 17% of women and 3% of men; cobalt and chromium are also known to cause allergies. Consumer exposure, particularly metal contact with the skin through jewelry or clothing, is the most prevalent, but not the most concerning. That’s reserved for metal allergies related to medical devices like coronary stents or hip and knee prostheses. And in dentistry, there are rare occasions of inflammation or rashes from metal amalgam fillings.
Which brings us to dental implants: the main metal post that’s inserted into the jawbone is usually made of titanium. It’s the metal of choice for two reasons: it’s bio-compatible, meaning the body normally accepts its presence; and it’s osteophilic, which means bone cells readily grow and adhere to it, a major reason for implant durability.
While it’s possible for someone to have an allergy and subsequent reaction to implants with titanium, the occurrences appear to be extremely low. In one study of 1,500 patients, titanium allergies were estimated to be a factor in implant failures in less than 1% of those studied.
Even so, if you have known metal allergies you should make sure your dentist knows. Being aware of all the facts will help them recommend the best tooth replacement choice for you—and hopefully it will be dental implants.
If you would like more information on dental implant restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Metal Allergies to Dental Implants.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
People who’ve lost all their teeth (a condition known as edentulism) face a decision on how to restore their lost function and appearance. And there are a number of options to consider.
A fixed bridge supported by dental implants, for example, is a good choice for patients who still have sufficient bone structure in their jaw. It’s not a good choice, however, for those with the opposite situation — who’ve experienced significant bone loss which has also affected their facial structure. For them, there’s a better alternative that also uses implants for support — the overdenture.
An overdenture is similar to a traditional denture, in that it’s made of life-like crowns permanently set in denture plastic, and may either partially or fully cover the roof of the mouth. The main difference, though, is that unlike traditional dentures which rest for support on the gum ridges, an overdenture is supported by strategically placed implants that the denture fits over and connects to — hence the name “overdenture.”
There are a number of advantages for an overdenture, especially for patients with bone loss. A removable, implant-supported denture can be designed to replace lost tissues that have altered facial appearance — to “fill in” the face and restore aesthetic harmony. Patients who’ve previously worn dentures will also often find their speech better improved than with fixed bridgework.
Because it’s removable, an overdenture and the underlying gums are easier to clean, which helps inhibit disease and lessen further bone loss. It also allows you to properly care for the denture, which can extend its longevity and reduce future potential maintenance and replacement costs.
If you would like to consider removable overdentures as an option, you should begin first with a thorough oral exam that includes evaluating the status of your bone, jaw and facial structure. From there we can advise you if overdentures are the best choice for you.
If you would like more information on overdentures and other restoration options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fixed vs. Removable.”
We’ve come a long way in our ability to restore missing teeth. Today’s top choice is dental implants, prized not only for their close resemblance to real teeth but also their durability.
The rise of implants, though, hasn’t put older restorative methods out to pasture—many continue to offer patients a viable and affordable choice for tooth replacement. One example is the removable partial denture (RPD).
Once quite common, RPDs’ popularity has only slightly diminished with the advent of implants. They’re a fair option in terms of dental function and appearance, and much less expensive than implants or fixed bridges.
Similar to a full denture—a removable appliance that replaces all the teeth on a dental arch—a RPD can replace multiple missing teeth in a variety of configurations. A traditional RPD is usually constructed of vitallium, a lightweight but strong metal alloy, which allows for a very thin and comfortable frame. It’s covered in a gum-colored resin or plastic with prosthetic (false) teeth precisely set at the missing teeth’s locations. The appliance stays in place through a series of clasps that attach to the remaining teeth.
Each RPD is custom-made to fit a patient’s mouth contours and the locations and patterns of the missing teeth. The top design goal for each individual RPD is to minimize any rocking movement during chewing; achieving that goal will depend not only on how many teeth are missing and where, but also what type of teeth are being replaced. For example, teeth missing from the back would require a different support design than teeth missing from the side or front.
RPDs’ biggest benefits are comfortable fit, effective dental function and good appearance. However, their means of attachment can create difficulties keeping remaining teeth clean of disease-causing bacterial plaque. Furthermore, an ill-fitting or unstable RPD could damage or even loosen natural teeth. It’s therefore essential for wearers to diligently practice daily hygiene (including cleaning the RPD) and undergo regular fit monitoring with their dentist.
Even with these constraints, a RPD can do an acceptable job providing dental function. What’s more, it can definitely improve your smile.
If you would like more information on options for dental restoration, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”
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